Marilyn Kae Mathern, LCPC, LAC
Individual provider Active NPI Professional Counselor · Great Falls, MT
NPI 1386974020 · NPPES record last updated Jun 16, 2010
Key facts
- NPI
- 1386974020
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 1458LCPC (MT)
- Practice address
- 1601 2ND Ave N
Ste. 622
Great Falls, MT 59401-3259 - Phone
- (406) 781-4457
- Fax
- (406) 452-9040
- NPI assigned
- Dec 31, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1267LAC | MT | MD | Addiction (Substance Use Disorder) Counselor |
| 1458LCPC | MT | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1267LAC | MT | |
| Professional Counselor | 101YP2500X | 1458LCPC | MT | Yes |
Addresses
Primary practice location
1601 2ND Ave N
Ste. 622
Great Falls, MT 59401-3259
Mailing address
1601 2ND Ave N
Ste. 622
Great Falls, MT 59401-3259
Phone (406) 781-4457
Other providers in Great Falls, MT
- Jessica Elaine Martinez
- Rafael Martinez
- Ali Marzooq
- Michael Lee Mason
- Christine Masters
- Meghan Mathes
- Nicholas Arthur Mathias
- Robert James Mathison
- Thomas H Matsko
- Matthew B Martin DDS Inc
All providers in Great Falls, MT · Professional Counselor in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.